Question

Imagine yourself as night-shift charge nurse on a medical-surgical unit. For several months you have had a problem with a staff nurse whose performance you consider unsatisfactory. She seems to continually take advantage of quiet times during her shift to doze off at the nursing station. You have orally reprimanded her several times for sleeping on the job, and you have reached the point where you believe you can no longer simply scold her for her conduct. Her position, however, is “it’s no big deal,” that she's always certain to hear any call signals as long as she's at the nursing station. (Your hospital has a clear policy concerning written warnings, the policy is relatively loose concerning all oral warnings; these can be unlimited and issued at your discretion, so you can deliver as many as you believe necessary.)

For written warning to become official and the entered into an employee's personal file, it must be agreed to and countersigned by the unit nurse manager and the director of nursing. You issued the offending nurse two written warnings, both cleared only through the unit manager. However, you believe you can go no further without backing from the director of nursing, and there has been no follow-up from that direction. Meanwhile, the employee continues to be a problem.

1. What recourse, if any, do you have in pursuing the disciplinary policy in the manner described in the case? You know the disciplinary policy list “sleeping on the job” as an infraction.

Answer 1

1. First, try counselling the defaulting nurse. Try understanding the real problem and guide how she can over come it. If help required from management, then matter can be put up to TM.

2. Reprimand and oral warnings regarding the consequences of failing to abide by the rules and regulations

3. Still no improvement, then written memo

4. Even if the written memo has not been successful in causing improvement in her behavior, the matter must be escalated to top management.

5. The top management can themselves try to get the nurse to follow the rules of the firm, else she has to be discharged of her duties, as any lapse can cause patient's life to be endangered and medical negligence can occur.